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The Royal College of Psychiatrists Improving the lives of people with mental illness

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ECTAS Standards

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Developing evidence-based standards

The accreditation standards have been drawn from key documents including the ECT Handbook (Royal College of Psychiatrists, 2013), the NICE Appraisal of ECT (National Institute of Clinical Excellence, 2003) and the Scottish National Audit of ECT (CRAG Working Group on Mental Illness, 2000). They have been subject to extensive consultation with all professional group involved in ECT and with service users and their representatives.


What the ECTAS Standards cover

The standards are intended to provide staff with a clear and comprehensive description of best practice in the administration of ECT. They are reviewed in October every year and published in December.

The standards cover the following topics:

  • The ECT Clinic and Facilities
  • Staff and Training
  • Assessment and Preparation
  • Consent and Information Giving
  • Anaesthetic Practice
  • The Administration of ECT
  • Recovery, Monitoring and Follow-up
  • Special Precautions
  • Protocols
  • Clinics Practising Nurse-Administered ECT (added in Thirteenth Edition, 2016)


How we measure performance against standards

The full set of standards are aspirational and it is rare that any clinic meets all of them. To support their use in the accreditation process, each standard has been categorised as follows:

  • Type 1: Essential standards. Failure to meet these would result in a significant threat to patient safety, rights or dignity and/or would breach the law. These standards also include the fundamentals of care, including the provision of evidence based care and treatment;
  • Type 2: Expected standards that all services should meet;
  • Type 3: Desirable standards that high performing services should meet. .

These standards relate to the process of administration of ECT for both inpatients and outpatients, and in this regard are consistent with NICE guidelines. They do not relate to clinical decisions about which patients should be given ECT.

In order to be accredited, a clinic must meet:

  • 100% type 1 standards
  • 80% type 2 standards
  • 60% type 3 standards

Clinics that do not meet the threshold for accreditation when their case is considered by the ECTAS Accreditation Committee will usually have their accreditation deferred by 3 or 6 months (length of deferral agreed by the Committee). They will be given specific advice on the standards to address and asked for evidence that these standards have been addressed before the deferral period ends, at which point the Committee may decide that the clinic meets these standards and may be accredited.

Clinics may be given 'not accredited' status if they fail to meet sufficient standards and do not demonstrate the ability to meet them within a reasonable timeframe, or if they fail to submit sufficient data for a full review to take place.


ECTAS, 21 Prescot Street, London, E1 8BB

Tel: 020 3701 2653    Fax: 020 3701 2761      Email:




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